NPI 1093713356 DR. EDWARD MARVIN GOTLIEB MD STONE MOUNTAIN GA. Find Phone Number, Address, Contact details of medical healthcare providers | NPI Number Lookup

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Dr. Edward Marvin Gotlieb - NPI: 1093713356

National Provider Identifier (NPI) is a 10-digit identification number which is issued to health care providers by the Centers for Medicare and Medicaid Services (CMS) in the United States(US). The NPI is introduced to replace of UPIN (unique provider identification number) and now NPI is the only required identifier for Medicare services, and NPI is also used by commercial healthcare insurers and by other payers.

Doctor Name: DR. EDWARD MARVIN GOTLIEB
NPI Number: 1093713356
Entity Type Code: Individual (1)
Gender: M
Credentials: MD
License Number: 014500
Business Practice Address: 5405 Memorial Dr
Building D Stone Mountain, GA - 300833234
Business Phone Number: 4042963800
Business Fax Number: 4042978753
Mailing Address: 5405 Memorial Dr, Building D
STONE MOUNTAIN
State: GA
Postal Code: 300833234
Phone Number: 4042963800
Fax Number: 4042978753
NPI Enumeration Date: 07/11/2005
NPI Last Update Date: 09/28/2011
Replacement NPI: 0
NPI Deactivation Date:
NPI Reactivation Date:

Taxonomy Information:

Healthcare Provider Taxonomy: 2080A0000X
License Number: 014500
Healthcare Provider Taxonomy:
(Secondary)
Y
State: GA
Taxonomy Type: Allopathic & Osteopathic Physicians
Taxonomy Classification: Pediatrics
Taxonomy Specialization: Adolescent Medicine
Taxonomy Definition:
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.


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